[Raynaud's disease and syndrome. Presentation of clinical experience]

The Authors report their experience concerning 256 cases of Raynaud's Disease and Syndrome observed from 1968 to 1987; 23 patients underwent surgery for the treatment of dystrophic or gangrenous lesions of the extremities (12 cervico-thoracic and 8 lumbar sympathectomies, 1 popliteal aneurysmectomy, 2 scalenotomies): a significant improvement of the clinical picture was observed in 91.30% of the patients who underwent the operation. The pharmacologic treatment obtained satisfactory results in 51.26% of all the patients. The Authors propose a three stage classification of raynaudian symptoms: I stage: sporadic vasoconstrictive crises; II stage: recurrent vasoconstrictive crises not invalidating working activity and "restitutio ad integrum" between attacks; III stage: recurrent and frequent crises invalidating working activity with asphyxia and/or ulcer-gangrene of the extremities. Both pharmacological and surgical treatment obtained the improvement of the clinical condition to an inferior stage in a high rate of patients. In three patients only (two of whom underwent scalenotomy and one popliteal aneurysmectomy) the complete and definitive cessation of raynaudian crises was observed.